Giant cell myocarditis in a patient with a spondyloarthropathy after a drug hypersensitivity reaction.

A young woman thought to have seronegative rheumatoid arthritis developed Stevens-Johnson syndrome after treatment with sulfasalazine; this resolved with prednisone. Later she was found to be HLA-B27-positive in keeping with a spondyloarthropathy. Soon afterward, she developed clinical myopericarditis and cardiogenic shock that responded initially to methylprednisolone and intravenous immunoglobulin, but recurred. An endomyocardial biopsy demonstrated active myocarditis with a mixed cell composition including rare giant cells, but not enough to classify it as giant cell myocarditis. Heart failure symptoms returned and she eventually required a heart transplant; the explanted heart showed giant cell myocarditis. Copyright © 2013 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Citation

Peter R Mitoff, Thierry G Mesana, Lisa M Mielniczuk, Jackie Grenon, John P Veinot, Leslie T Cooper, Ross A Davies. Giant cell myocarditis in a patient with a spondyloarthropathy after a drug hypersensitivity reaction. The Canadian journal of cardiology. 2013 Sep;29(9):1138.e7-8

PMID: 23474137

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